The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV
Date
2016-12
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis
Abstract
Background: Bronchoscopy is an important investigation in the diagnosis and management of childhood respiratory diseases widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC).
Aims and Objectives:
Aim of this study was to describe the indications, findings and complications of paediatric bronchoscopy in a middle income country with a high prevalence of tuberculosis (TB) and HIV.
Methodology:
A retrospective analysis of a database which included all bronchoscopies on neonates and children over a 3.5 year period (January 2010 to June 2013) in a tertiary care children’s hospital in South Africa.
Results and Discussion:
A total of 509 bronchoscopies, of which 502 (98%) were fibre-optic bronchoscopies, were performed on neonates (2.3%) and children (median age = 18 months; range 1 day- 14.6 years)( (male=58%) of which 5.1% were HIV-infected. The main indications were: large airway compression 40% (n = 204) complicated pneumonia (25 %) and persistent stridor (15 %). Pathology was observed in 64% (n = 319) of bronchoscopes . The most common pathology seen was lymph node compression of the airways (21%), and upper airway pathology (12%). Interventional procedures were performed in 112 cases (22%), the commonest being removing foreign bodies removal (30%), endobronchial lymph node enucleation (30%) and transbronchial needle aspiration (20%). No major complications occurred during or following bronchoscopy.
Conclusion
The diagnostic yield of paediatric bronchoscopy did not significantly differ from those reported from high income countries emphasising the importance of paediatric bronchoscopy in the management of childhood lung disease in LMICs.
Description
CITATION: Webster, I., Goussard, P., Gie, R., Janson, J. & Rossouw, G. 2017. The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV. Expert Review of Respiratory Medicine, 11(2):159-165, doi:10.1080/17476348.2017.1280397.
The original publication is available at https://www.tandfonline.com/toc/ierx20/current
The original publication is available at https://www.tandfonline.com/toc/ierx20/current
Keywords
Paediatric bronchoscopy, Respiratory diseases in children -- Diagnosis -- South Africa, Pediatric respiratory diseases -- Diagnosis -- South Africa, Pulmonary tuberculosis -- Diagnosis -- South Africa, Tuberculosis and HIV -- South Africa
Citation
Webster, I., Goussard, P., Gie, R., Janson, J. & Rossouw, G. 2017. The indications and role of paediatric bronchoscopy in a developing country, with high prevalence of pulmonary tuberculosis and HIV. Expert Review of Respiratory Medicine, 11(2):159-165, doi:10.1080/17476348.2017.1280397.